WA to delay opening of Perth Children's Hospital if necessary: Hames

Written by Kate McDonald on 25 August 2015.

The West Australian government will delay the opening of the $1.2 billion Perth Children's Hospital (PCH) if necessary as it seeks to avoid the same problems experienced with the commissioning and opening of Fiona Stanley Hospital (FSH).

WA Health Minister Kim Hames told ABC News today that he was “nervous” about whether the hospital would be completed on time. The opening of the hospital would be delayed if construction was not completed by November 30 as the government would take five months from whatever date it received the keys, Dr Hames said.

The opening of the hospital has already been delayed by several months. Originally scheduled to open at the end of the year, Dr Hames informed parliament in March that it was more likely to be in April 2016.

The West Australian reported reported today that the project managers could not guarantee when it would open, except to say it would be in the first half of 2016.

Fears have been raised about the ICT systems being planned for the hospital, which is due to open with the BOSSnet digital medical record (DMR) being rolled out throughout WA rather than the integrated electronic medical record (EMR) originally envisaged.

This year's state budget showed that of the overall $179.15 million allocated for ICT at Perth Children's, over $100m was spent last year with $46.85m budgeted for this year.

As with Fiona Stanley, Perth Children's was expected to open with a fully integrated EMR, a tender for which was released last year. The tender has closed but there is no word as yet on the chosen vendor.

It has been widely rumoured that the preferred option of clinicians involved in the tender is Epic, which is used in both paediatric and adult hospitals in the US and is set to roll out at Royal Children's Hospital in Melbourne shortly.

In the meantime, Perth Children's will open with Core Medical Solutions' BOSSnet DMR, which came in for heated criticism at a parliamentary inquiry into the commissioning and opening of Fiona Stanley last week.

FSH intensive care specialist Ian Jenkins told the inquiry that the system would often freeze and had caused a “significant reduction” in efficiency. He also said it was untried in major Australian hospitals.

In its defence, industry sources have pointed out that BOSSnet is installed at Barwon Health's Geelong Hospital, a tertiary hospital with 400 beds, along with Western Health's Sunshine Hospital, which has 600 beds, and Footscray Hospital, which has 290. It is also being rolled out at the Epworth group of private hospitals in Melbourne.

Industry sources also told Pulse+IT that the problem of the system freezing was thought to be due to the virtualised environment rather than the software.

Dr Jenkins' criticism at the parliamentary inquiry followed an independent review released last month that said it often took 15 minutes for all of the applications required to manage a patient to open in the clinical system.

Pulse+IT's industry sources, who refused to be named, said the BOSSnet DMR was being blamed for lacking functionality that it was not contracted to provide.

However, Dr Jenkins told the inquiry that the problems at FSH were not just teething problems but a systemic issue.

“[It] goes right back to the meaningful engagement of clinicians, whether they be doctors or nurses, right back at the beginning,” he said.

“With a modern hospital, you start with planning your workflow and then you design your IT around that, and then you put the bricks and mortar around that to keep the cables and the servers dry.

“Whereas we had it the other way around: we had the building designed, it needed to look good, and then IT put in some whizzbang things, and a huge amount of time was wasted by planning workflow and so forth by people who were not necessarily experienced in it.”

Dr Jenkins was scathing in his criticism of Serco, which is responsible for all non-clinical operations at the hospital, and also drew attention to a problem with duress alarms that is plaguing mental health clinicians.

He also said the lack of fax machines at Fiona Stanley was limiting communications with GPs, and that one of the main problems was lack of interoperability between the DMR, standard WA Health systems like the patient administration system, pathology systems and GP systems.

“Interlinking the IT products that we have got now is the first step,” he said. “I think it is probably too late to turn the ship around at the new children’s hospital because of the time imperatives, but it is not an electronic medical record, and I think linking with GPs in a meaningful way is another big step.”

The Health Services Union, which represents many allied health professionals and clerical staff working at the hospital, submitted a survey it had carried out to the parliamentary inquiry. In addition to surveying members about their views on certain aspects of the hospital's operation, the HSU also included comments.

Some of the highlights include:

“The hospital building is brilliant. The workforce management model has been devised by lunatics who are too narcissistic to admit they are wrong”

“Too much time and money was spent on making sure the hospital looked good and had lots of fancy (but unnecessary) technology, while workforce planning especially at the clinical level was left to the last minute with an insufficient budget”

“I’m in IT so can only observe on that. The fundamental flaw was unrealistic expectations up front (eg. Paperless)”